背景：在成长中的患者中使用同种异体全颞下颌关节重建（TMJR）是有争议的，主要是由于颅颌面骨骼的未成熟元素。这项系统评价的目的是评估在成长中的患者中使用同种异体TMJR，专注于患者的临床表现，手术和病史和同种异体TMJR植入的疗效。
方法：文献检索策略以人口为基础，干预,比较器,成果和研究类型(PICOS)框架。我们搜索了Pubmed,谷歌学者，尺寸,WebofScience,X-mol,语义学者和Embase至2023年1月，对报告正在成长的患者中的同种异体TMJR的出版物类型没有任何限制（男孩年龄≤18岁，女孩年龄≤15岁）。
结果：共有15项研究（病例报告：09，病例系列：02，队列研究：04）符合纳入标准，记录了来自07个国家的73名年龄在增长的患者。38例(~52%)为女性。所有研究中患者的平均±SD（范围）年龄和随访时间为13.1±3.2（0-17）岁和34.3±21.5（7-96）个月，分别。共有22例（30％）患者植入了双侧同种异体TMJR。超过一半的研究（n=10）是在过去3年中发表的。所有患者在植入同种异体TMJR之前接受了多次手术。在极端情况下,患者共接受了17次手术。报告变量不一致的不同类型的研究限制了我们进行质量评估措施以建立证据的能力。
结论：在成长中的患者中使用同种异体TMJR的临床经验仅限于其他类型的重建预后不良的病例。然而，研究表明，在成长中的患者中使用同种异体TMJR有希望的结果，强调需要长期随访的良好控制的前瞻性研究。
BACKGROUND: The use of alloplastic total temporomandibular joint reconstruction (TMJR) in growing patients is controversial, mainly due to immature elements of the craniomaxillofacial skeleton. The aim of this systematic review was to evaluate the use of alloplastic TMJR in growing patients, focusing on the patient\'s clinical presentation, surgical and medical history and efficacy of alloplastic TMJR implantation.
METHODS: The literature search strategy was based on the Population, Intervention, Comparator, Outcomes and Study type (PICOS) framework. We searched Pubmed, Google Scholar, Dimension, Web of Science, X-mol, Semantic Scholar and Embase to January 2023, without any restriction on the type of publication reporting alloplastic TMJR in growing patients (age ≤ 18 years for boys and age ≤ 15 years for girls).
RESULTS: A total of 15 studies (case reports: 09, case series: 02, cohort studies: 04) met the inclusion criteria, documenting 73 patients of growing age from 07 countries. Thirty-eight (~ 52%) cases were female. The mean ± SD (range) age and follow-up of patients in all studies was 13.1 ± 3.2 (0-17) years and 34.3 ± 21.5 (7-96) months, respectively. A total of 22 (30%) patients were implanted with bilateral alloplastic TMJR. Over half of the studies (n = 10) were published in the last 3 years. All patients underwent multiple surgeries prior to implantation of alloplastic TMJR. In extreme cases, patients underwent a total of 17 surgeries. Different types of studies reporting inconsistent variables restricted our ability to perform quality assessment measures for evidence building.
CONCLUSIONS: Clinical experience with alloplastic TMJR in growing patients is limited to cases showing poor prognosis with other types of reconstruction. Nevertheless, studies show promising results for the use of alloplastic TMJR in growing patients, highlighting the need for well-controlled prospective studies with long-term follow-up.
